Initial Howard Brown Appointment: Beginning my Journey on Low Dose Testosterone

I wanted to share my experience with the first steps in accessing hormone therapy using informed consent at Howard Brown Health Center in Chicago, Illinois, both for my own personal record and to hopefully help others who are looking online for more information about the process. For those who are not familiar with Howard Brown, they are a LGBT health clinic that offers a variety of medical services, including transgender health care. They offer hormone therapy using an informed consent model, meaning that if you are at least 18 years of age it may be possible for you to be prescribed hormones without a traditional hormone letter from a therapist,  or without having lived in your gender role for a year, etc. I am not going to disclose the name of the doctor, hormone advocate or anyone else that I worked with, but I would suspect that my experience was fairly typical.

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End Game: Low Dose Testosterone and Transition

Currently I have an appointment at Howard Brown Health Center for mid June to begin the first steps in the process of hormone replacement therapy. For me, the decision to begin the process of medical transition was not an easy one. I have long been a worry-wart by nature, and at the age of 11 I had a major operation to remove a cyst from my leg. I recovered physically, but was left reeling emotionally – my little world had been shattered when I learned that I might be facing cancer or an amputation (thank god neither of these scenarios came to pass) Suddenly, going in for routine examinations caused anxiety attacks. I became convinced the doctor would find a horrific disease inside my body, and I avoided hearing this news by avoiding doctors. Suffice to say, I have lacked in medical care in recent years due to anxiety.

I have numerous concerns regarding testosterone use in an estrogen-based body system. With limited medical research and a small population, trans* folks face a lot of unknowns. Questions regarding increased risk of uterine, breast or ovarian cancers weigh on my mind. Gynecological complications, increase of high cholesterol or red blood count also give me pause. I have fought against acne since puberty to no avail – the idea of introducing more acne producing androgens into my system and worsening my already damaged skin is not something to take lightly. I do not want to have to take Accutane.

Will You Still Love Me Tomorrow?

 

Second, I have no support from my family in regards to transition (whether medically or socially). I was ‘outed’ by my parents in December of 2013, and my relationship with them has gone downhill since. After determining I was not welcome at Christmas, a series of negative interactions followed when I eventually told them my desire to take testosterone. Even after speaking to a therapist, my parents to this day have concluded that when I begin testosterone, I will cease to have a relationship with them (at this time, I have chosen not to tell them I will most likely start this summer). Financial or emotional support is completely out of the question, and even maintaining a civil relationship seems impossible at this point. My mother has told me to never speak to her again and that the daughter she knew is dead. My father told me I am abhorrent and a pseudo-male. Needless to say, the realization that my parent’s love was not unconditional was pretty hard to swallow. I suffered a panic attack and fell into a downward spiral. I wallowed in self pity and misery for several months, and nearly dragged my girlfriend down with me. It was only in recent months that I feel I have turned a mental corner towards brighter days. I have come to learn that my worth isn’t determined by my family, and that I am strong enough and brave enough to stand on my own. But that doesn’t mean it doesn’t hurt, and that I don’t get jealous when I see other folks with supportive parents. I fight hard against the anger that bubbles up whenever I see images or hear stories about parents and families accepting their transgender children with open arms – as happy as I am for those folks, the selfish part of me asks, why not me? Why can’t my parents accept me? What about me couldn’t they love?

One Step At a Time

 

Finally, I am not sure how far I want to go with my medical transition. I would love to have top surgery in the future, which I have no doubt about. But as far as hormones, I want to take it slow and see. I want to have time to process what is going on in my body and time to breathe. The stress of going through a second puberty in addition to the loss of very important family support systems may prove to be too much for my mental health. I am concerned about harming my body, either emotionally or physically, by rushing the hormones or taking too high a dose for me. I guess I am different from the majority of trans* folks I know in that regard- most of the folks I know are almost in a race of sorts to start hormones. I don’t know many trans* people who openly express doubts about hormones or a desire to take it slow. Part of the reason I wanted to document my journey on this blog is because there isn’t as much information out there about low dose testosterone as there is for a “standard” dose. I don’t know how long I want to be on hormones, or whether I will want to start and stop – I just know that I want to start slow, and continue until I reach my desired level of changes. At that point, I want to re evaluate, and decide from there. Too much worrying about the future doesn’t serve me, and I’ll leave it at that.

 

Identity: FTM, Genderqueer, Transmasculine, All or None?

“How do you identify?” This is probably my least favorite question to answer when someone asks me about my gender. There are all types of ways a person can answer this question, and everyone is different. I know some folks who embrace identity labels and other folks who refuse to use them. But at some level within ourselves, we are looking for an answer to these questions – who am I, how do I see myself, and how do I want others to see me?

Last year, when I first began researching why I felt so conflicted about my gender (female assigned at birth), I became aware of new ways to describe one’s identity that I had not heard of. I was familiar with the term transgender, but had limited knowledge of genderqueer, FTM, transmasculine, neutrois, etc. As I read more, I started to feel conflicted. Which one was me? I knew I did not identify as fully female despite having been born into a biological female body. Did any of these identities apply to me? What if I felt like I had a bit of all of them? It seemed that the more I learned, the more frustrated I felt at being unable to come up with a single term, or label, for my identity. I watched others around me seemingly settle onto a description of themselves, but I kept fluctuating. The unanswered question of my identity began to cause me anxiety.

What if I never find an identity that fully describes me?

 

This possibility – of never really settling onto a concept of self – has caused me to be uncomfortable, not only because in some ways I feel unsettled within myself, but more so because those in my life seem to demand an answer to the question of my identity. I understand that I don’t owe anybody an explanation of myself. It’s my business and mine alone, and who I choose to share that piece of my life with is entirely up to me. But I can’t lie – sometimes I feel it would be easier for me personally if I could just settle on a label and stick with it. But just when I think I’m settling on to something, a nagging feeling inside brings the question up again – are you sure?

Part of my reluctance to choose a label – transgender, ftm, male, queer, gender variant, etc– is the feeling that once I subscribe to a label I no longer have control over the path this sends me down (I think I’m starting to sound like a bit of a control freak). I guess what I mean is, I hate feeling that somebody can pop into Google whatever term I tell them I identity as and they can pull up a host of articles describing what someone ‘like me’ should look, act, or feel like. I also feel that one’s identity is not static, it changes over time. I may feel one way now, but I reserve the right to change my mind in the future. Explaining to people this evolving identity in my mind is a challenge. I have found that it is hard to get people who are unfamiliar with gender minorities to understand identities outside of the gender binary. An increasing number of folks are familiar with the term transgender, but I have yet to find someone familiar with the term genderqueer who did not already have a solid background in gender minorities.

I Can Only Be the Change I Wish to See

 

Not everything is a war inside my head though. There are some things that I know with great certainty about myself, and these things don’t fluctuate. First, I am not comfortable being read as female. I am completely uncomfortable with female pronouns. When I am referred to as “daughter”, “ma’am” or ‘she,” an internal buzzer goes off inside my head that yells – hey, watch your mouth, I’m not female! I am not sure what causes this reaction other than to say I want to be read and treated as male, and being read and treated as female in social settings causes me a lot of internal conflict. I don’t see myself as a girl, but everyone else seems to, so I feel in a constant state of conflict.

Second, I am completely uncomfortable with wearing any type of feminine clothing. I would rather wear a blanket than wear any type of feminine clothing. Dresses and skirts have made me so uncomfortable since preschool age that my parents gave up their effort early on to have me wear something other than boy shorts and tees. Obviously I recognize that feminine clothing does not necessarily equate to feminine identity- but for me, my truth is that any type of feminine flair in my own personal clothing or gender presentation makes me completely uncomfortable.

Third, the parts of my body that give me away as biologically female cause me dysphoria. In particular, my voice, chest, facial structure, and fat distribution (hips). I find myself longing, needing, to have the traits of a male or masculine body. Since puberty I have had some facial hair – a light mustache and a decent amount of chin hair, thanks genetics! – but I have a deep desire to increase my body hair (everywhere). I weight lift with an emphasis on upper body strength in an attempt to create a more male appearing body. I always wear a binder, or if unable, a tight sports bra. I dream daily of having a male chest.

All that aside, I do not experience ‘bottom’ dysphoria, and have zero desire to have bottom surgery. I also recognize that I have some feminine aspects to my personality and I enjoy these – I am a communicator, I am sensitive, I am nurturing. I was raised and socialized to be female so I have a lot of experience working and living with others in that role. I understand female social circles and friendships and feel comfortable in them. I have great respect for the women in my life and I am not blind to male privilege. I feel I can relate to those who struggle against the patriarchy. Because I identified as female for the vast majority of my relatively young life, I have a hard time saying that I don’t have any parts of my self that are female. However, despite recognizing the truth that I have some feminine aspects of my personality that I enjoy, the overwhelming truth of my life is this deep burning desire to be read and treated as male, and to have a masculine body. For me this is not a matter of wishing I were a boy, as I once thought – instead, it is a need to look in the mirror and have the person staring back at me reflect how I view my internal self, and that is masculine.

Into the Unknown

 

So those are my truths. But how far I want to go in my medical transition is a question that remains unanswered (and saved for another post). For now, I use the term queer when describing my identity to others, because I find its lack of hard lines and boundaries liberating. When I was brainstorming a name for this blog (on which I plan to record my journey) I struggled again with how to describe my life. Finally I decided that it didn’t matter what anybody else thought of me, or what they think I am, all that mattered was that I was true to myself. And that is why I describe my transition as female-to-me. Other people may be comfortable with other labels, but for me, the end goal of my transition is to feel comfortable in my own skin, to see ME when I look in the mirror. I need to spend less time worrying about identity labels and more time worrying about making myself happy. And I know masculinizing my body will make me happy.

When I ask myself the same questions I brought up at the beginning of this post, the answers come up the same no matter how many times I ask them – who am I? (I’m just ME) How do I see myself? (masculine of center) How do I want others to see me? (male)

As anxious as it might make me, I know that part of life is embracing the unknown, and doing what both scares and excites you. This is why I am so sure that the right decision for me is to start low dose testosterone (assuming my doctor agrees this is appropriate). I do not know what the future holds for me, but I am confident that in time I will find my true self. This is my beginning.